Neuro exam

A patient with polyneuropathy secondary to diabetes mellitus type 2 might present with:

• Sensory loss in a glove and stocking pattern

• Sensory loss within 1 or 2 isolated dermatomes

• Sensory loss in one half of the body (right arm and right leg for example)

• Loss of pain and temperature but not proprioception in the same limb

Pain (sharp/dull) information is relayed via which spinal pathway?

• Anterolateral spinothalamic

• Dorsal column medial lemniscus

• Lateral corticospinal

• Reticulospinal

Having the patient describe random items placed in their hand with vision occluded describes which combined cortical sensory test?

• Graphesthesia

• Two-point discrimination

• Sensory extinction

• Stereognosis

Evaluating the pupillary response to light tests which cranial nerve(s)?

• Cranial nerve II

• Cranial nerve III

• Cranial nerves II & III

• Cranial nerves III, IV, & VI

In testing cranial nerve VIII; which test finding suggests a sensorineural hearing loss?

• When sound is lateralized to the side experiencing the hearing loss

• If during the Rinne test, the patient hears the vibration longer on the mastoid process

• If during the Rinne test, the patient cannot perceive vibration when the tuning fork is placed on the mastoid process

• If during the Weber test, the patient cannot perceive vibration when the tuning fork is placed on the mastoid process

A score of 1+ on the Modified Ashworth Scale (MAS) indicates:

• A normal finding

• Slight increase in muscle tone manifested by a catch, followed by minimal resistance throughout the remainder of the available ROM (< 1/2)

• Slight increase in muscle tone characterized by a brief catch, followed by a release

• Considerable increase in muscle tone with resistance through most of the available ROM (> 1/2) but the limb is still easily moved

A deep tendon reflex (DTR) grade of 2+ indicates:

• An average response

• A slight but definitely present response

• A brisk response (greater than what would be expected)

• A brisk response (greater than what would be expected) + 2-3 beats of clonus

In which condition might we expect the patient to become extremely reliant on visual information, such that motor coordination tests (such as finger to nose), are substantially harder when the patient is required to repeat the test with the eyes closed?

• Cerebellar ataxia

• Sensory ataxia

• Parkinson's Disease (PD)

• Huntington's Disease

An example of an equilibrium coordination test is:

• Rapidly alternating forearm pronation and supination

• Finger to nose

• Walking backwards

• Sliding the heel up the contralateral shin

Dyssynergia (or movement decomposition) describes:

• Impaired motor coordination of the muscles responsible for speech

• Difficulty with rapid alternating movements

• Under or overshooting when reaching for a target

• Movement performed in a sequence of component parts rather than a single activity